Certified Emergency Nurse (CEN) Practice Test

Distributive shock leads to decreased cellular perfusion due to what mechanism?

1. Obstruction of blood flow

2. Maldistribution of oxygen to the periphery

3. Failure of the heart's pumping ability

4. A lack of circulating blood volume

The correct answer is: Maldistribution of oxygen to the periphery

Distributive shock is characterized by a paradoxical situation where there is sufficient blood volume, yet cells are unable to receive the necessary oxygen and nutrients they need. This phenomenon occurs primarily due to the maldistribution of blood flow, which ultimately leads to decreased cellular perfusion. In distributive shock, often seen in conditions like septic shock, neurogenic shock, or anaphylactic shock, the blood vessels become excessively dilated. This dilation disrupts the normal distribution of blood flow within the vascular system, causing significant areas of tissue to receive inadequate blood supply despite the presence of normal or even elevated systemic blood volume. As a result, while the heart may be effectively pumping blood, and volume may be adequate, the perfusion at the cellular level suffers, leading to tissue hypoxia and cellular dysfunction. This mechanism is crucial to understand, as it intricately connects the physiological responses leading to compromised cellular health during distributive shock, differentiating it from the other forms of shock that involve obstruction, heart failure, or decreased blood volume.